Wellcare Health Plans uses VirtualHealth’s care-management platform because of its Medicare, State medicaid programs and lengthy-term services and supports programs in 19 states, the 2 companies announced Thursday.
“This partnership will let us really innovate delivery of care directly for the people,” stated Darren Ghanayem, chief information officer of Wellcare, that has 4.3 million people. The Tampa, Fla.-based insurer provides government-backed managed-care services, mostly through State medicaid programs, Medicare Advantage and Medicare prescription medication plans.
Included in the partnership, VirtualHealth will aggregate health data from electronic health records, claims along with other sources, standardize them in one location, and evaluate them for population health purposes.
“With the data in one location and everybody working in one location, you are able to run really advanced predictive analytics and risk stratification,” stated VirtualHealth Chief executive officer Adam Sabloff. Such stratification allows the 2 organizations to recognize and manage Wellcare’s high-risk people.
“Using the way situations are going, particularly with the Aetna-CVS merger, we are moving perfectly into a positive look at the healthcare system,” Sabloff stated. VirtualHealth’s platform promotes that view, he added.
“A part of our delivery model would be to make certain the providers are giving the highest quality outcomes and not simply getting reimbursed according to a task,” Ghanayem stated. VirtualHealth will support that model by informing what Wellcare recommends to enhance patients’ health. “It may be as easy as recommending someone get strategy to high bloodstream pressure with medication,” Ghanayem stated.
Their bond occurs the heels of VirtualHealth’s announcement, late this past year, of $seven million in new funding. The finish of the season was less auspicious for Wellcare. An old general counsel from the insurer was sentenced to 6 several weeks imprisonment for submitting false documents towards the Florida State medicaid programs Program. Earlier in 2017, the CMS announced it might fine Wellcare $1.17 million for violating Medicare needs for prescription medication plan problems.